Social care’s best practice agency to get more power but at what cost?

This week, community care minister Stephen Ladyman is expected
to rubberstamp the proposed transfer of seven key government
agencies to the Social Care Institute for Excellence.

The move, exclusively revealed by Community Care, could
fundamentally change the remit of the institute and its
relationship with government.

It has led some to ask how an organisation that was set up to
independently verify and spread best practice in social care can
continue fulfilling this role when it is to become so tied to
government.

In comparison to Scie’s current size and £5m budget, the scale
of the deal is enormous. It will involve the transfer of around 150
staff and £30m worth of funding from the Department of
Health’s Care Services Improvement Partnership. This is made up of
the National Institute for Mental Health in England (NIMHE),
Valuing People Support Team, Health and Social Care Change Agent
Team, National Child and Adolescent Mental Health Services Support
Service, Integrated Care Network, Integrated Community Equipment
Support Team and Change for Children.

Most of the partnership’s work will be run from NIMHE’s existing
eight regional centres, with a small number of staff based at
Scie’s offices near London Bridge. Staff will remain employed by
the individual agencies but the work they do will be promoted as
Scie’s.

Alternatives to the integration model were considered, but barriers
surrounding how the improvement partnership agencies would fit with
Scie’s charitable status ruled these out. It is likely the
relationship, work and targets of this new “division” of Scie will
be governed by a service level agreement with the DoH.

The new division will be headed up by a director reporting to the
chief executive – senior DoH civil servant Richard Humphries is to
oversee the transfer as interim director. With the permanent
appointee likely to be one of the existing improvement partnership
division heads there could be serious implications for Scie’s
existing senior management.

There appear to be a number of advantages to the move, notably
around increasing Scie’s profile, dissemination capabilities and
ability to do primary research.

However, there are also a number of risks around maintaining
transferred staff’s terms of employment and Scie’s social care
focus being diluted because the NHS currently has better access to
the improvement partnership’s programmes than the social care
sector.

By far the biggest question for Scie, though, is whether its
independence will be affected by the new arrangements. This is
partly a perception issue, but one that has dominated Scie’s
thinking while refining the proposals – it recommends a
communications strategy to counter suggestions it is an agency of
the DoH and for its independence to be stressed at the announcement
of the initiative.

But this alone will not be enough. Factors such as the possibility
the director could be seconded to the DoH for a time and that part
of the service level agreement will involve negotiating with the
DoH over work programmes may fuel concerns the department is
pulling Scie’s strings.

Indeed, Scie has suggested developing a protocol for resolving
conflicts between itself and the department when they do not agree
that an improvement directive is good practice or evidence-based.
It has also accepted it will have to demonstrate to the Charities
Commission its independence from government.

One senior social services figure, who wishes to remain anonymous,
believes the move will bring fundamental change to Scie, with it
moving away from identifying better knowledge and practice to
promoting new legislation and government advice.

He explains: “All these agencies are expected to promote government
policy and best practice – for example NIMHE is expected to promote
new mental health legislation. This is not what Scie was set up
for. The government is going to expect a return on its money and
Scie will end up delivering what it wants to happen.”

He adds that the government is likely to turn to Scie to deliver
recommendations on best practice in the recruitment and retention
of social workers in the adult social care green paper later this
year. “I think it will be seen as taking on the functions of an
agency of government.”

Many academics are also concerned. “There’s always been a question
about its independence but I wonder whether this means Scie is no
different to a government-run think-tank,” says one. “There have
been signs of Scie moving into a more advisory and development role
rather than assessing the knowledge base.”

However, John Ransford, chair of the Local Government Association
and a founder of Scie, says its independence was important to the
department when it was established.

“It should be seen as good news that the policy and management [of
the seven DoH agencies] are going to be with an independent
institute. I can understand concerns about compromise, but [Scie
chair] Jane Campbell is the embodiment of independence,” he
adds.

Scie says it will only go ahead with the transfer if it gets
assurances that its independence, emphasis on service users and
social care focus will all be retained.

If these reassurances are not forthcoming, the implications for the
improvement partnership and Scie are uncertain. “This is a big
opportunity for Scie, but if it doesn’t take it on, what will it
mean for its future?” asks one social services director.

An institute and its critics.  

A director of one well-known organisation that has worked with
the Social Care Institute for Excellence sums up the feelings of
many when he describes it as an organisation that has “a lot of
money and swank premises” but is failing to be at the leading edge
of professional development.  

“Their annual conference is an expensive joke. They compare
unfavourably with the National Institute for Clinical
Excellence…and while they publish some interesting material,
universities could do it more efficiently and effectively,” he
adds.  

Scie, predictably, says the criticisms are ill-informed, and has
issued a statement that says: “Scie has a much wider remit than
Nice, and the purpose of our conference is to give a platform to
service user views and experience as well as to disseminate work to
practitioners and managers.” 

The institute insists that Stephen Ladyman’s support for the
transfer is “a strong indication” of his confidence in its ability
to take forward the improvement agenda.  

Some inside government, the academic community and some
practitioners say Scie is “esoteric, too academic and lacks
profile” and has been “colonised by the service-user
movement”.  

Scie rejects this claim as “negative and insulting”, showing a
failure to grasp the changing nature of social care.  

“It is commonly accepted that service users need a stronger
voice if services and practice are to be improved,” Scie says in a
statement. 

There is little doubt one of the motivations behind the move is
a desire by ministers to see a bigger, more powerful Scie and one
which can increase the social care profile within the improvement
partnership programmes.  

The move would also enable the institute to do its own primary
research – the lack of which has given rise to some of the
criticism of its work.  

Professor of interprofessional health and social studies at
Anglia Polytechnic University Shula Ramon says: “I am disappointed
with the lack of primary research at Scie, but I don’t think it
denigrates what it has done. Scie can be used and is accessible but
I think it needs to invest more in ensuring practitioners use
it.”